This application is for a NIH Career Award through the Faculty Transition Phase of the NIDCR Scholar Development and Faculty Transition Award. This application proposes a comprehensive interdisciplinary program of necessary training and mentorship to develop into an independent investigator. The applicant has an established record of commitment and interest in research and academic dentistry. Problem: There are significant disparities in access to dental care in this country, particularly for low-income children and those with special health care needs. Purpose: This project investigates disparities in access to dental care and pediatric performance measures of oral health care provided to children (1-18 years) enrolled in public insurance programs that currently exist in North Carolina and Virginia. Methods: North Carolina's (NC) public insurance dental plans (Medicaid/SCHIP) are administered as fee-for-service programs, while Virginia's (VA) publicly insured children are enrolled in both managed care organizations and fee-for-service dental programs. This project will examine the impact of health care organizational factors such as managed care versus fee-for-service programs and the difference in plan performance measures on pediatric oral health outcomes. Aims: The first study will describe the dynamics of enrollment and the access to dental services over a three-year period (2001-2003) of publicly insured children in both states. The second study will examine the performance of dental plans (utilization, effectiveness of prevention and quality) for children over this three-year period. The third study will examine the likelihood of hospital use versus the conventional dental setting for enrolled children 1-5 years of age. The fourth study is a feasibility project aimed at exploring the clinical implications of oral health case management in the medical arena. Benefit: This mix of quantitative techniques and a clinical study will be utilized to address the NIDCR Priority Research Area of eliminating oral health disparities. [unreadable] [unreadable]